Are the Treatment and Prevention of Obesity Different Problems?

When I visited the Pacific island of Nauru in the early 1980s it was populated by the kind of human mastodons who have since become extremely common in the United States and elsewhere. Half of the Nauruans were diabetic, the reason being a combination of genetic propensity, physical inactivity, and a taste for sweet drinks such as Fanta and Chateau Yquem, which they drank in vast quantities. Life expectancy was very low.

A recent edition of the New England Journal of Medicine is largely devoted to the relation of sweet drinks to obesity. It reports, for example, a controlled trial in Holland in which children were divided randomly into two groups, those who received sugar-sweetened drinks and those who received non-calorifically sweetened drinks. The children were aged between 4 and 11, and the parents gave their consent, the children their "assent," to the experiment, which lasted on average 18 months.

After 18 months, the children who had drunk sugar-sweetened drinks had put on a kilo (2.2 pounds) of weight by comparison with those who had drunk similar quantities of artificially sweetened drinks. Those who had drunk the sugar-sweetened drinks had grown slightly but statistically significantly taller than those who had drunk the artificially sweetened drinks (the Dutch, incidentally, are now the tallest people in the world); when adjusted for the difference in height, the sugar-sweetened drinks accounted for 0.8 kilos (1.7 pounds) of the weight gain.

These results are important for the United States, because the quantities of sweet drinks consumed in the Dutch trial were far lower than those consumed, on average, by American children. They will give some comfort to Mayor Bloomberg in his campaign against sugar-sweetened drinks.